Hormone imbalance causing many issues

[S2e34]

Hi everyone

I wondered if any one else had these symptoms that I have? I will list the problems below hopefully someone can give some advice. 🙏

Age 29
Height 5 ft 5
Weight 86 kg

When I was 16 my friends mum took me to the clinic and myself and my friend started taking microgynon 30, all was well and I took it into my late teens. I then had to change pill as I was having irregular spotting. Fast forward over the past 10 years and every single pill had caused me to bleed for around 3 weeks out of each pack. On or off the pill I have balooned in size, I used to be a size 10-12 and im now a size 16. The positives of taking the pill do include not getting greasy skin and no face or body acne.

I stopped taking my latest pill (cilest) due to the bleeding and the “normal” symptoms have returned such as, ovulation coming back which was so painful this month that I almost had to go to a&e and I physically couldn’t move my husband would have had to carry me, painful heavy periods, spots on face, giant spots on my chest, back and shoulders that are so large that they leave a hole/scar, and finally the oil!!! I’ve been washing my hair every day, my chest, back, shoulders, face , hair and ears are so oily and it smells so strong it’s so embarrassing.

So after all of these years the GP has prescribed me microgynon again, and suggested to try and keep taking different pills hoping that one of them is right and stops the spotting. My last pill I took for 1 year and still had spotting. I had one abdominal scan and one transvaginal scan and a smear test, they found fibroids but didn’t mention seeing anything else. They referred me to the gynaecologist but my appointment isn’t until august.

I decided after the excruciating 3 day pain I had this ovulation and the spots, that I am going to start the pill again, then see how things go. Im due on my period next week and im dreading that pain.

My question is, does anyone think that polysistic ovaries show on a scan? Or endometriosis? Could the fibroids be causing any of these symptoms as the GP was hesitant to refer me to the gynaecologist for the fibroids as he said that they are quite common. He then said I suppose I can give you a referral if you are worried, so he has done. Is all of this normal or is there a connection between the pill not being able to balance itself out and regulate my bleeding and then the obvious imbalance in the hormones without the pill, which I can see due to the symptoms.

Could someone let me know if I potentially could have something else wrong? I am worried to go back to the GP as they keep getting a male GP to phone me back and sometimes when I ask him women’s questions he says that he doesn’t know the answer. He phones me back most times and I am not sure if I should specify on my e consult that I would rather speak with someone else, also should I just wait until August to see the consultant?

Thank you

What you need first and foremost is a diagnosis. Am glad to read you have a referral.

The spotting may be hormonal in nature and its been a long term problem as well. PCOS may be the root cause of this; it sounds like your body is trying and failing to ovulate.

The pill has anti androgenic qualities hence your lack of problems associated with hirsuitism and your skin whilst on it. Again acne and oily skin can be associated with PCOS but this is a very individualistic disorder that affects each woman with it very differently.

Endometriosis is a common cause of severe period or mid cycle pain and ovulation should not be that bloody painful. Any pain that is cyclical in nature and or gets worse up to and including menses should be investigated to see if endometriosis is present. This is not normally detected on internal ultrasound scans; the usual way this is diagnosed is through a keyhole surgery op called a laparoscopy.

The cystic follicles associated with PCOS can disappear, only to be replaced by further cystic follicles. Did the sonographer not mention the appearance of your ovaries on the internal scan?. Polycystic ovaries can have a ring of pearls appearance and are larger than a normal sized ovary which is walnut size.

If you do not already do so I would keep a daily pain and symptom diary to show the consultant in August. Would suggest you not go on your own to that initial appointment if at all possible but if you're on your own take your diary with you. Ask lots of questions and write them down beforehand; you do not want to leave there thinking, "oh I should have asked about x".

Do specify on the e-consult form that you would like to speak to another doctor within the practice.

Agree with @AttilaTheMeerkat's excellent answer above and would add that if you think it's PCOS, ask your doctor to do blood tests to check your LH and FSH levels and to do a ultrasound scan to check your ovaries for the classic 'ring of pearls'. In my experience, PCOS is poorly understood by GP's despite it being extremely common in women and you really do have to push to be taken seriously.

@AttilaTheMeerkat thank you for taking the time to reply, the information was very helpful. I will start adding to my diary now.